Physician Compare National (NPI:1790733228)

HEALTHCARE PROVIDER: GLEN CURTIS FRIEDMAN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1790733228
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406768274
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050325000485
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FRIEDMAN
	Individual professional last name
Provider First Name	GLEN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	PATHOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DESERT PATHOLOGY SERVICES PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0143276006
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1801 N OREGON ST PATHOLOGY DEPT
	Group Practice or individual's line 1 address
Line 2 Street Address	LAS PALMAS MEDICAL CENTER
	Group Practice or individual's line 2 address
City	EL PASO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	799023524
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9155211341
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAS PALMAS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y